Background: One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are aff ecting the number of adults with diabetes. Methods: We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence-defined as fasting plasma glucose of 7.0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral... (More)

Background: One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are aff ecting the number of adults with diabetes. Methods: We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence-defined as fasting plasma glucose of 7.0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs-in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue. Findings: We used data from 751 studies including 4372000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4.3% (95% credible interval 2.4-17.0) in 1980 to 9.0% (7.2-11.1) in 2014 in men, and from 5.0% (2.9-7.9) to 7.9% (6.4-9.7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28.5% due to the rise in prevalence, 39.7% due to population growth and ageing, and 31.8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (>30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target. Interpretation: Since 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults aff ected, has increased faster in low-income and middle-income countries than in high-income countries.

@article{083cdfb3-9ff5-434f-95bf-aa6bbdbeedb1,
abstract = {<p>Background: One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are aff ecting the number of adults with diabetes. Methods: We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence-defined as fasting plasma glucose of 7.0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs-in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue. Findings: We used data from 751 studies including 4372000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4.3% (95% credible interval 2.4-17.0) in 1980 to 9.0% (7.2-11.1) in 2014 in men, and from 5.0% (2.9-7.9) to 7.9% (6.4-9.7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28.5% due to the rise in prevalence, 39.7% due to population growth and ageing, and 31.8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (&gt;30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target. Interpretation: Since 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults aff ected, has increased faster in low-income and middle-income countries than in high-income countries.</p>},
author = {Zhou, Bin and Lu, Yuan and Hajifathalian, Kaveh and Bentham, James and Di Cesare, Mariachiara and Danaei, Goodarz and Bixby, Honor and Cowan, Melanie J. and Ali, Mohammed K. and Taddei, Cristina and Lo, Wei Cheng and Reis-Santos, Barbara and Stevens, Gretchen A. and Riley, Leanne M. and Miranda, J. Jaime and Bjerregaard, Peter and Rivera, Juan A. and Fouad, Heba M. and Ma, Guansheng and Mbanya, Jean Claude N and McGarvey, Stephen T. and Mohan, Viswanathan and Onat, Altan and Pilav, Aida and Ramachandran, Ambady and Ben Romdhane, Habiba and Paciorek, Christopher J. and Bennett, James E. and Ezzati, Majid and Abdeen, Ziad A. and Kadir, Khalid Abdul and Abu-Rmeileh, Niveen M. and Acosta-Cazares, Benjamin and Adams, Robert and Aekplakorn, Wichai and Aguilar-Salinas, Carlos A. and Agyemang, Charles and Ahmadvand, Alireza and Al-Othman, Amani Rashed and Alkerwi, Ala'a and Amouyel, Philippe and Amuzu, Antoinette and Bo Andersen, Lars and Anderssen, Sigmund A. and Anjana, Ranjit Mohan and Aounallah-Skhiri, Hajer and Aris, Tahir and Arlappa, Nimmathota and Arveiler, Dominique and Assah, Felix K. and Avdicová, Mária and Azizi, Fereidoun and Balakrishna, Nagalla and Bandosz, Piotr and Barbagallo, Carlo M. and Barceló, Alberto and Batieha, Anwar M. and Baur, Louise A. and Benet, Mikhail and Bernabe-Ortiz, Antonio and Bharadwaj, Sumit and Bhargava, Santosh K. and Bi, Yufang and Bjertness, Espen and Bjertness, Marius B. and Björkelund, Cecilia and Blokstra, Anneke and Bo, Simona and Boehm, Bernhard O. and Boissonnet, Carlos P. and Bovet, Pascal and Brajkovich, Imperia and Breckenkamp, Juergen and Brenner, Hermann and Brewster, Lizzy M. and Brian, Garry R. and Bruno, Graziella and Bugge, Anna and De León, Antonio Cabrera and Can, Günay and Cåndido, Ana Paula C and Capuano, Vincenzo and Carlsson, Axel C. and Carvalho, Maria J. and Casanueva, Felipe F. and Casas, Juan Pablo and Caserta, Carmelo A. and Castetbon, Katia and Chamukuttan, Snehalatha and Chaturvedi, Nishi and Chen, Chien Jen and Chen, Fangfang and Chen, Shuohua and Cheng, Ching Yu and Chetrit, Angela and Chiou, Shu Ti and Cho, Yumi and Chudek, Jerzy and Cifkova, Renata and Claessens, Frank and Concin, Hans and Cooper, Cyrus and Cooper, Rachel and Costanzo, Simona and Cottel, Dominique and Cowell, Chris and Crujeiras, Ana B. and D'Arrigo, Graziella and Dallongeville, Jean and Dankner, Rachel and Dauchet, Luc and De Gaetano, Giovanni and De Henauw, Stefaan and Deepa, Mohan and Dehghan, Abbas and Deschamps, Valerie and Dhana, Klodian and Di Castelnuovo, Augusto F. and Djalalinia, Shirin and Doua, Kouamelan and Drygas, Wojciech and Du, Yong and Dzerve, Vilnis and Egbagbe, Eruke E. and Eggertsen, Robert and El Ati, Jalila and Elosua, Roberto and Erasmus, Rajiv T. and Erem, Cihangir and Ergor, Gul and Eriksen, Louise and Escobedo-De La Peña, Jorge and Fall, Caroline H. and Farzadfar, Farshad and Felix-Redondo, Francisco J. and Ferguson, Trevor S. and Fernández-Bergés, Daniel and Ferrari, Marika and Ferreccio, Catterina and Feskens, Edith J M and Finn, Joseph D. and Föger, Bernhard and Foo, Leng Huat and Forslund, Ann Sofie and Francis, Damian K. and Do Carmo Franco, Maria and Franco, Oscar H. and Frontera, Guillermo and Furusawa, Takuro and Gaciong, Zbigniew and Garnett, Sarah P. and Gaspoz, Jean Michel and Gasull, Magda and Gates, Louise and Geleijnse, Johanna M. and Ghasemian, Anoosheh and Ghimire, Anup and Giampaoli, Simona and Gianfagna, Francesco and Giovannelli, Jonathan and Giwercman, Aleksander and Gross, Marcela Gonzalez and Rivas, Juan P González and Gorbea, Mariano Bonet and Gottrand, Frederic and Grafnetter, Dušan and Grodzicki, Tomasz and Grøntved, Anders and Gruden, Grabriella and Gu, Dongfeng and Guan, Ong Peng and Guerrero, Ramiro and Guessous, Idris and Guimaraes, Andre L. and Gutierrez, Laura and Hambleton, Ian R. and Hardy, Rebecca and Kumar, Rachakulla Hari and Hata, Jun and He, Jiang and Heidemann, Christin and Herrala, Sauli and Hihtaniemi, Ilpo Tapani and Ho, Sai Yin and Ho, Suzanne C. and Hofman, Albert and Hormiga, Claudia M. and Horta, Bernardo L. and Houti, Leila and Howitt, Christina and Htay, Thein Thein and Htet, Aung Soe and Htike, Maung Maung Than and Hu, Yang and Hussieni, Abdullatif S. and Huybrechts, Inge and Hwalla, Nahla and Iacoviello, Licia and Iannone, Anna G. and Ibrahim, M. Mohsen and Ikeda, Nayu and Ikram, M. Arfan and Irazola, Vilma E. and Islam, Muhammad and Iwasaki, Masanori and Jacobs, Jeremy M. and Jafar, Tazeen and Jamil, Kazi M. and Jasienska, Grazyna and Jiang, Chao Qiang and Jonas, Jost B. and Joshi, Pradeep and Kafatos, Anthony and Kalter-Leibovici, Ofra and Kasaeian, Amir and Katz, Joanne and Kaur, Prabhdeep and Kavousi, Maryam and Keinänen-Kiukaanniemi, Sirkka and Kelishadi, Roya and Kengne, Andre P. and Kersting, Mathilde and Khader, Yousef Saleh and Khalili, Davood and Khang, Young Ho and Kiechl, Stefan and Kim, Jeongseon and Kolsteren, Patrick and Korrovits, Paul and Kratzer, Wolfgang and Kromhout, Daan and Kujala, Urho M. and Kula, Krzysztof and Kyobutungi, Catherine and Laatikainen, Tiina and Lachat, Carl and Laid, Youcef and Lam, Tai Hing and Landrove, Orlando and Lanska, Vera and Lappas, Georg and Laxmaiah, Avula and Leclercq, Catherine and Lee, Jeannette and Lee, Jeonghee and Lehtimäki, Terho and Lekhraj, Rampal and León-Muñoz, Luz M. and Li, Yanping and Lim, Wei Yen and Lima-Costa, M. Fernanda and Lin, Hsien Ho and Lin, Xu and Lissner, Lauren and Lorbeer, Roberto and Lozano, José Eugenio and Luksiene, Dalia and Lundqvist, Annamari and Lytsy, Per and Machado-Coelho, George L L and Machi, Suka and Maggi, Stefania and Magliano, Dianna J. and Makdisse, Marcia and Rao, Kodavanti Mallikharjuna and Manios, Yannis and Manzato, Enzo and Margozzini, Paula and Marques-Vidal, Pedro and Martorell, Reynaldo and Masoodi, Shariq R. and Mathiesen, Ellisiv B. and Matsha, Tandi E. and McFarlane, Shelly R. and McLachlan, Stela and McNulty, Breige A. and Mediene-Benchekor, Sounnia and Meirhaeghe, Aline and Menezes, Ana Maria B and Merat, Shahin and Meshram, Indrapal I. and Mi, Jie and Miquel, Juan Francisco and Mohamed, Mostafa K. and Mohammad, Kazem and Mohammadifard, Noushin and Mohd Yusoff, Muhammad Fadhli and Møller, Niels C. and Molnár, Dénes and Mondo, Charles K. and Morejon, Alain and Moreno, Luis A. and Morgan, Karen and Moschonis, George and Mossakowska, Malgorzata and Mostafa, Aya and Mota, Jorge and Motta, Jorge and Mu, Thet Thet and Muiesan, Maria Lorenza and Müller-Nurasyid, Martina and Mursu, Jaakko and Nagel, Gabriele and Námešná, Jana and Nang, Ei Ei K and Nangia, Vinay B. and Navarrete-Muñoz, Eva Maria and Ndiaye, Ndeye Coumba and Nenko, Ilona and Nervi, Flavio and Nguyen, Nguyen D. and Nguyen, Quang Ngoc and Nieto-Martínez, Ramfis E. and Ning, Guang and Ninomiya, Toshiharu and Noale, Marianna and Noto, Davide and Al Nsour, Mohannad and Ochoa-Avilés, Angélica M. and Oh, Kyungwon and Ordunez, Pedro and Osmond, Clive and Otero, Johanna A. and Owusu-Dabo, Ellis and Pahomova, Elena and Palmieri, Luigi and Panda-Jonas, Songhomitra and Panza, Francesco and Parsaeian, Mahboubeh and Peixoto, Sergio Viana and Peltonen, Markku and Peters, Annette and Peykari, Niloofar and Pham, Son Thai and Pitakaka, Freda and Piwonska, Aleksandra and Piwonski, Jerzy and Plans-Rubió, Pedro and Porta, Miquel and Portegies, Marileen L P and Poustchi, Hossein and Pradeepa, Rajendra and Price, Jacqueline F. and Punab, Margus and Qasrawi, Radwan F. and Qorbani, Mostafa and Radisauskas, Ricardas and Rahman, Mahmudur and Raitakari, Olli and Rao, Sudha Ramachandra and Ramke, Jacqueline and Ramos, Rafel and Rampal, Sanjay and Rathmann, Wolfgang and Redon, Josep and Reganit, Paul Ferdinand M and Rigo, Fernando and Robinson, Sian M. and Robitaille, Cynthia and Rodríguez-Artalejo, Fernando and Del CristoRodriguez-Perez, María and Rodríguez-Villamizar, Laura A. and Rojas-Martinez, Rosalba and Ronkainen, Kimmo and Rosengren, Annika and Rubinstein, Adolfo and Rui, Ornelas and Ruiz-Betancourt, Blanca Sandra and Horimoto, Andrea R V Russo and Rutkowski, Marcin and Sabanayagam, Charumathi and Sachdev, Harshpal S. and Saidi, Olfa and Sakarya, Sibel and Salanave, Benoit and Salonen, Jukka T. and Salvetti, Massimo and Sánchez-Abanto, Jose and Santos, Diana and Dos Santos, Renata Nunes and Santos, Rute and Saramies, Jouko L. and Sardinha, Luis B. and Sarrafzadegan, Nizal and Saum, Kai Uwe and Scazufca, Marcia and Schargrodsky, Herman and Scheidt-Nave, Christa and Sein, Aye Aye and Sharma, Sanjb K. and Shaw, Jonathan E. and Shibuya, Kenji and Shin, Youchan and Shiri, Rahman and Siantar, Rosalynn and Sibai, Abla M. and Simon, Mary and Simons, Judith and Simons, Leon A. and Sjostrom, Michael and Slowikowska-Hilczer, Jolanta and Slusarczyk, Przemyslaw and Smeeth, Liam and Snijder, Marieke B. and So, Hung Kwan and Sobngwi, Eugène and Söderberg, Stefan and Solfrizzi, Vincenzo and Sonestedt, Emily and Soumare, Aicha and Staessen, Jan A. and Stathopoulou, Maria G. and Steene-Johannessen, Jostein and Stehle, Peter and Stein, Aryeh D. and Stessman, Jochanan and Stöckl, Doris and Stokwiszewski, Jakub and Stronks, Karien and Strufaldi, Maria Wany and Sun, Chien An and Sundström, Johan and Sung, Yn Tz and Suriyawongpaisal, Paibul and Sy, Rody G. and Tai, E. Shyong and Tamosiunas, Abdonas and Tang, Line and Tarawneh, Mohammed and Tarqui-Mamani, Carolina B. and Taylor, Anne and Theobald, Holger and Thijs, Lutgarde and Thuesen, Betina H. and Tolonen, Hanna K. and Tolstrup, Janne S. and Topbas, Murat and Torrent, Maties and Traissac, Pierre and Trinh, Oanh T H and Tulloch-Reid, Marshall K. and Tuomainen, Tomi Pekka and Turley, Maria L. and Tzourio, Christophe and Ueda, Peter and Ukoli, Flora A M and Ulmer, Hanno and Uusitalo, Hannu M T and Valdivia, Gonzalo and Valvi, Damaskini and Van Rossem, Lenie and Van Valkengoed, Irene G M and Vanderschueren, Dirk and Vanuzzo, Diego and Vega, Tomas and Velasquez-Melendez, Gustavo and Veronesi, Giovanni and Verschuren, W. M Monique and Verstraeten, Roosmarijn and Viet, Lucie and Vioque, Jesus and Virtanen, Jyrki K. and Visvikis-Siest, Sophie and Viswanathan, Bharathi and Vollenweider, Peter and Voutilainen, Sari and Vrijheid, Martine and Wade, Alisha N. and Wagner, Aline and Walton, Janette and Wan Mohamud, Wan Nazaimoon and Wang, Feng and Wang, Ming Dong and Wang, Qian and Wang, Ya Xing and Wannamethee, S. Goya and Weerasekera, Deepa and Whincup, Peter H. and Widhalm, Kurt and Wiecek, Andrzej and Wijga, Alet H. and Wilks, Rainford J. and Willeit, Johann and Wilsgaard, Tom and Wojtyniak, Bogdan and Wong, Tien Yin and Woo, Jean and Woodward, Mark and Wu, Frederick C. and Wu, Shou Ling and Xu, Haiquan and Yan, Weili and Yang, Xiaoguang and Ye, Xingwang and Yoshihara, Akihiro and Younger-Coleman, Novie O. and Zambon, Sabina and Zargar, Abdul Hamid and Zdrojewski, Tomasz and Zhao, Wenhua and Zheng, Yingfeng and Cisneros, Julio Zuñiga},
issn = {0140-6736},
language = {eng},
month = {04},
number = {10027},
pages = {1513--1530},
publisher = {Elsevier Limited},
series = {The Lancet},
title = {Worldwide trends in diabetes since 1980 : A pooled analysis of 751 population-based studies with 4.4 million participants},
url = {http://dx.doi.org/10.1016/S0140-6736(16)00618-8},
volume = {387},
year = {2016},
}